Published online Mar 15, 2018. doi: 10.4251/wjgo.v10.i3.91
Peer-review started: December 5, 2017
First decision: January 3, 2018
Revised: January 9, 2018
Accepted: February 3, 2018
Article in press: February 3, 2018
Published online: March 15, 2018
The patient underwent resection for rectal adenocarcinoma presented metastases to the liver and lung with epigastric pain and jaundice.
The patient was diagnosed with obstructive jaundice.
Primary pancreatobiliary carcinoma or pancreatic metastasis from colon cancer.
Laboratory evaluation revealed the findings of obstructive jaundice.
The patient was diagnosed with obstructive jaundice due to primary pancreatic ductal adenocarcinoma.
Immunohistochemical findings of the cell block sections obtained using the Trefle® endoscopic scraper were consistent with those of previous resected specimens, confirming the final diagnosis of pancreatic metastasis from colon cancer.
A covered self-expanding metal stent was inserted to resolve the symptoms and establish biliary drainage and the third-line chemotherapy regimen for colon cancer was administered.
There have been few reports dealing with the combination of a scraper Trefle® and cell block method for histocytological diagnosis of malignant biliary strictures.
The combination of the cell block technique and the Trefle® device shows promise for diagnosis of biliary strictures as it is as easy as conventional brush cytology.